Published: Sunday, March 31, 2013 at 12:34 a.m.

Last Modified: Sunday, March 31, 2013 at 12:34 a.m.

Jason Ramsey is a cyber baseball coach of sorts. Sitting in his recliner with flip-flops and gym shorts on, he spent a recent afternoon watching videos of a rising batter from New Bern and emailing pointers to improve the boy's stance and swing.

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There is reason Ramsey does not coach the novice in person: A crippling anxiety disorder, coupled with resulting physical ailments, confines the one-time star collegiate pitcher in his home, as it has for the past several years.

The ability to feel anxious is an invaluable survival mechanism because it makes the brain and body more alert.

But millions of Americans have trouble turning down the voltage, causing a life-altering disorder that forces sufferers to avoid any situation that triggers stress or panic.

“Thanks to our evolutionary history, we have systems in the brain that are dedicated to detecting threat and avoiding harm,” said Jordan W. Smoller, professor of psychiatry at Harvard Medical School. “In essence, these same systems have kind of gone awry in the case of anxiety disorder.”

Ramsey's story offers a window into this mental illness, a condition for which treatment, while effective, remains widely out of reach. It is the story of a contender whose abrupt deterioration illustrates the power of the mind over the body, and even how the fear of fear may overshadow fear itself.

During his baseball career at the University of North Carolina Wilmington in the mid-1990s, Ramsey rose to prominence as a mentally tough stalwart able to withstand the strongest of pressures. His hard-to-hit changeup befuddled even the best batters. A scout from the New York Yankees praised him as a “competitor and a bulldog,” a pitcher whose throws were “always around the plate.”

But in his junior year, anxiety began playing havoc on Ramsey's psyche. Frequent vomiting between pitches prompted him to stuff Pepto-Bismol in his back pocket. He summoned his catcher to the mound and the two pretended to strategize to give Ramsey time to catch his breath. His coach during one game drove him to the emergency room because Ramsey was scared of keeling over dead because his heart pounded so hard. His condition worsened to the point that he was forced to forgo his senior season.

“I was in a 24-hour, seven-day-a-week panic,” Ramsey recalled. “I was sick to my stomach every single day. I threw up all day long, every day. I had chest pains every day, all day, and that would escalate into a panic attack, where your heart, you feel like you can't breathe. It was like somebody was choking the life out of me.”

“You wish somebody would shoot you,” he added later.

A walking enigma

Now 37 and living in Jacksonville, Ramsey rarely ventures from his house for fear of panic setting in. His only forays outside involve doctor visits or buying 52-ounce fountain drinks from the gas station a quarter-mile away.

“He was probably one of the most fearless competitors that I remember playing with,” said Joey Pyrtle, a UNCW teammate who signed with the New York Mets in 1995. “He handled those pressure situations with such ease and grace, and then to see the other side, with what he has struggled with, it's hard to wrap my head around.”

Anxiety disorders often go untreated for long periods. Some are mistaken for cardiac conditions because they mimic feelings associated with heart attacks – rapid heartbeat, shortness of breath and chest pain. The sense of impending doom and dizziness grows so severe in some cases that sufferers avoid whatever situation triggered it. For Ramsey, that could be something as simple as getting out of bed.

Scientists have made great strides in their understanding of anxiety disorders over the last few decades, aiding in the development of treatments that many find effective.

“Anxiety is very common, but it's probably the most curable emotional problem because you're born with the ability to relax,” said Richard Campbell, a clinical psychologist who specializes in treating competitive athletes.

Mental health advocates in recent decades have placed emphasis on training physicians and emergency room doctors to recognize the signs and symptoms of anxiety. But significant gaps remain.

“The majority do not get proper treatment or are not properly diagnosed,” said Jonathan Abramowitz, the University of North Carolina at Chapel Hill's associate chairman of psychology. “Even though we've come a long way, we have a long way to go.”

Ramsey, who bears a specific anxiety disorder known as panic disorder, is trying to figure out whether all his symptoms are truly anxiety-related or the result of something else. His fears stem from family history: Both his father and uncle died from heart attacks in their 40s, and his grandfather had several heart attacks before ultimately dying of a stroke. Today, Ramsey worries about clogged arteries, and has visited the emergency room dozens of times for worry his heart is about to stop.

Todd Farchione, Boston University's research assistant professor who directs the Intensive Treatment Program for Panic Disorder and Specific Phobias, said individuals with panic disorder often reveal a history of watching family members go through severe health complications. Those experiences, he said, lead to worries about their own physical well-being and cause them to focus in on their bodily processes.

With Ramsey's father somewhat estranged, he forged a close bond with his grandfather. So his death took a particularly hard toll when Ramsey was a junior at UNCW in 1996.

“I was already thinking at that age what I had to look forward to. And that was scary,” said Ramsey, adding later that “from there, as quick as you can flush a toilet, is how fast my health went.”

Scientists believe both genetics and environment play a role in the development of anxiety disorders, but to what degree remains a matter of debate. People in higher-stress occupations, including competitive athletes whose every move is scrutinized, may be especially vulnerable.

Anxiety disorder may lead to other health complications, and possibly shorten life expectancy.

Smoller, the Harvard professor, said a study of 3,300 women who reported a panic attack in the prior six months had an increased risk of stroke, cardiovascular disease and mortality over the next five years.

A formidable force

Raised in Jacksonville, Ramsey gained a love for baseball early on. He played Little League but didn't hone his talents until high school. Several colleges expressed interest, but he ultimately chose UNCW in part because of its proximity to his family.

Though not the strongest pitcher, Ramsey garnered a reputation among his fellow Seahawks for his acumen on the mound. Fine-tuned mechanics and pinpoint accuracy made him a formidable force. He nearly broke UNCW's all-time strikeout record before anxiety sank his career.

Ramsey got the shot of his lifetime during his sophomore year. That summer, he won entry into the Cape Cod League, widely acknowledged as one of the most prestigious summer leagues in the country. The opportunity allowed him to showcase his talents in front of dozens of professional scouts. He left feeling confident in his major league prospects, like a new door had opened.

“I made sure I did anything and everything I could do, so if I didn't get drafted, I could live with myself,” he said. “The bad thing that happened is it got taken from me because of my health.”

Pressure mounted as Ramsey drove to succeed. Failures left him with a lingering sense of guilt. He remembers today how one of his coaches kicked over a bucket of balls when, as a freshman, he walked in a winning run. And how he drew ire for going against a coach's recommendation to throw a certain pitch and instead threw another, resulting in a run.

Two factors worked against Ramsey. For one, at 5-foot-7, he stood shorter than a vast majority of major league players. Also, his fastball topped out at 89 mph. When a doctor in college suggested Ramsey undergo surgery to correct an elbow injury, he refused out of fear of losing even a smidgen of speed.

Junior season brought new misfortunes. Biggest of all happened when he found his grandfather lying motionless on the floor of his home. The grandfather suffered a stroke and fell into a coma. He died soon afterward at Onslow Memorial Hospital, with Ramsey by his side.

From there, Ramsey's health declined. He began experiencing chest pain and other panic-like symptoms. After a while he had trouble standing on the field without feeling nauseous.

He still remembers the last pitch he threw: “a fastball,” he recalled without hesitation.

Still, after managing to graduate in 1998, he landed a series of teaching and coaching jobs in Wilmington and Jacksonville. But panic continued to plague him.

Brian Stewart, who previously worked with Ramsey at Hoggard High School and now coaches Ashley, recalled how Ramsey once had a panic attack when Jacksonville played Ashley. Ramsey was the only licensed driver with the Jacksonville team, but was in poor shape. So Stewart drove the bus for him back to Jacksonville.

By 2005, Ramsey's condition forced him onto government disability, where he remains.

Comfort zone

He lives in a modest house on the edge of Jacksonville with his mother and 14-year-old son. He had the garage remodeled into what resembles a studio apartment, a comfort zone he rarely leaves. (He chuckled recently about how he had never stepped foot in his backyard.) His den includes a living room area with recliners, a couch and a big-screen television for watching ESPN. A pass-through opens into his bedroom so friends can sit and talk to him at the counter when he feels too ill to sit upright.

Up until a few months ago, Ramsey said he spent 24 hours a day in bed. The hair on his right leg had worn off from lying down. Now, he manages to spend a few hours out of bed, often on a tablet posting messages about baseball to NCPreps.com.

Though open about his condition, one might have trouble believing Ramsey has an anxiety disorder just by talking to him. He cracks jokes and carries on conversations with the skill of a sportscaster. And memory seems to come easy. Ask him and he quickly recalls statistics from games he played, pitches he threw and even batters who got a hit off him.

Memorabilia is scattered around the house – old pictures, newspaper clippings and magazines stuffed into cabinets and drawers. He picks them up and points to different players, recalling where their careers took them.

He felt well enough earlier this month to visit a private indoor batting cage in a warehouse owned by a friend off a gravel road a mile or so from his home. He dropped several balls into the pitching machine and watched as they flew across home plate, remembering when he used to do the throwing.

During a phone conversation later that week, Ramsey said the father of the boy to whom he had provided pointers via email called and the two spoke for three hours. Now the father and son planned to visit Ramsey, including possibly a trip to the batting cage.

“I told him, ‘I might be able to last 30 minutes; I might be able to last an hour,' ” said Ramsey, sounding excited. “He doesn't care. He's just appreciative.”

<p>Jason Ramsey is a cyber baseball coach of sorts. Sitting in his recliner with flip-flops and gym shorts on, he spent a recent afternoon watching videos of a rising batter from New Bern and emailing pointers to improve the boy's stance and swing. </p><p>There is reason Ramsey does not coach the novice in person: A crippling anxiety disorder, coupled with resulting physical ailments, confines the one-time star collegiate pitcher in his home, as it has for the past several years.</p><p>The ability to feel anxious is an invaluable survival mechanism because it makes the brain and body more alert.</p><p>But millions of Americans have trouble turning down the voltage, causing a life-altering disorder that forces sufferers to avoid any situation that triggers stress or panic. </p><p>“Thanks to our evolutionary history, we have systems in the brain that are dedicated to detecting threat and avoiding harm,” said Jordan W. Smoller, professor of psychiatry at Harvard Medical School. “In essence, these same systems have kind of gone awry in the case of anxiety disorder.”</p><p>Ramsey's story offers a window into this mental illness, a condition for which treatment, while effective, remains widely out of reach. It is the story of a contender whose abrupt deterioration illustrates the power of the mind over the body, and even how the fear of fear may overshadow fear itself. </p><p>During his baseball career at the University of North Carolina Wilmington in the mid-1990s, Ramsey rose to prominence as a mentally tough stalwart able to withstand the strongest of pressures. His hard-to-hit changeup befuddled even the best batters. A scout from the New York Yankees praised him as a “competitor and a bulldog,” a pitcher whose throws were “always around the plate.” </p><p>But in his junior year, anxiety began playing havoc on Ramsey's psyche. Frequent vomiting between pitches prompted him to stuff Pepto-Bismol in his back pocket. He summoned his catcher to the mound and the two pretended to strategize to give Ramsey time to catch his breath. His coach during one game drove him to the emergency room because Ramsey was scared of keeling over dead because his heart pounded so hard. His condition worsened to the point that he was forced to forgo his senior season. </p><p>“I was in a 24-hour, seven-day-a-week panic,” Ramsey recalled. “I was sick to my stomach every single day. I threw up all day long, every day. I had chest pains every day, all day, and that would escalate into a panic attack, where your heart, you feel like you can't breathe. It was like somebody was choking the life out of me.” </p><p>“You wish somebody would shoot you,” he added later.</p><h3>A walking enigma</h3>
<p>Now 37 and living in Jacksonville, Ramsey rarely ventures from his house for fear of panic setting in. His only forays outside involve doctor visits or buying 52-ounce fountain drinks from the gas station a quarter-mile away. </p><p>Such a surprising turnabout – from unwavering athlete to homebound agoraphobic – makes Ramsey a walking enigma. </p><p>“He was probably one of the most fearless competitors that I remember playing with,” said Joey Pyrtle, a <a href="http://www.starnewsonline.com/section/topic71"><b>UNCW</b></a> teammate who signed with the New York Mets in 1995. “He handled those pressure situations with such ease and grace, and then to see the other side, with what he has struggled with, it's hard to wrap my head around.”</p><p>Anxiety disorders often go untreated for long periods. Some are mistaken for cardiac conditions because they mimic feelings associated with heart attacks – rapid heartbeat, shortness of breath and chest pain. The sense of impending doom and dizziness grows so severe in some cases that sufferers avoid whatever situation triggered it. For Ramsey, that could be something as simple as getting out of bed. </p><p>Scientists have made great strides in their understanding of anxiety disorders over the last few decades, aiding in the development of treatments that many find effective. </p><p>“Anxiety is very common, but it's probably the most curable emotional problem because you're born with the ability to relax,” said Richard Campbell, a clinical psychologist who specializes in treating competitive athletes. </p><p>But despite headway, two obstacles remain: expanding access to therapy and erasing the stigma surrounding mental health issues. </p><p>Mental health advocates in recent decades have placed emphasis on training physicians and emergency room doctors to recognize the signs and symptoms of anxiety. But significant gaps remain. </p><p>“The majority do not get proper treatment or are not properly diagnosed,” said Jonathan Abramowitz, the University of North Carolina at Chapel Hill's associate chairman of psychology. “Even though we've come a long way, we have a long way to go.” </p><p>Ramsey, who bears a specific anxiety disorder known as panic disorder, is trying to figure out whether all his symptoms are truly anxiety-related or the result of something else. His fears stem from family history: Both his father and uncle died from heart attacks in their 40s, and his grandfather had several heart attacks before ultimately dying of a stroke. Today, Ramsey worries about clogged arteries, and has visited the emergency room dozens of times for worry his heart is about to stop. </p><p>Todd Farchione, Boston University's research assistant professor who directs the Intensive Treatment Program for Panic Disorder and Specific Phobias, said individuals with panic disorder often reveal a history of watching family members go through severe health complications. Those experiences, he said, lead to worries about their own physical well-being and cause them to focus in on their bodily processes. </p><p>With Ramsey's father somewhat estranged, he forged a close bond with his grandfather. So his death took a particularly hard toll when Ramsey was a junior at UNCW in 1996. </p><p>“I was already thinking at that age what I had to look forward to. And that was scary,” said Ramsey, adding later that “from there, as quick as you can flush a toilet, is how fast my health went.” </p><p>Scientists believe both genetics and environment play a role in the development of anxiety disorders, but to what degree remains a matter of debate. People in higher-stress occupations, including competitive athletes whose every move is scrutinized, may be especially vulnerable.</p><p>Anxiety disorder may lead to other health complications, and possibly shorten life expectancy. </p><p>Smoller, the Harvard professor, said a study of 3,300 women who reported a panic attack in the prior six months had an increased risk of stroke, cardiovascular disease and mortality over the next five years.</p><h3>A formidable force</h3>
<p>Raised in Jacksonville, Ramsey gained a love for baseball early on. He played Little League but didn't hone his talents until high school. Several colleges expressed interest, but he ultimately chose <a href="http://www.starnewsonline.com/section/topic71"><b>UNCW</b></a> in part because of its proximity to his family. </p><p>Though not the strongest pitcher, Ramsey garnered a reputation among his fellow Seahawks for his acumen on the mound. Fine-tuned mechanics and pinpoint accuracy made him a formidable force. He nearly broke UNCW's all-time strikeout record before anxiety sank his career. </p><p>Ramsey got the shot of his lifetime during his sophomore year. That summer, he won entry into the Cape Cod League, widely acknowledged as one of the most prestigious summer leagues in the country. The opportunity allowed him to showcase his talents in front of dozens of professional scouts. He left feeling confident in his major league prospects, like a new door had opened. </p><p>“I made sure I did anything and everything I could do, so if I didn't get drafted, I could live with myself,” he said. “The bad thing that happened is it got taken from me because of my health.”</p><p>Pressure mounted as Ramsey drove to succeed. Failures left him with a lingering sense of guilt. He remembers today how one of his coaches kicked over a bucket of balls when, as a freshman, he walked in a winning run. And how he drew ire for going against a coach's recommendation to throw a certain pitch and instead threw another, resulting in a run. </p><p>Two factors worked against Ramsey. For one, at 5-foot-7, he stood shorter than a vast majority of major league players. Also, his fastball topped out at 89 mph. When a doctor in college suggested Ramsey undergo surgery to correct an elbow injury, he refused out of fear of losing even a smidgen of speed. </p><p>Junior season brought new misfortunes. Biggest of all happened when he found his grandfather lying motionless on the floor of his home. The grandfather suffered a stroke and fell into a coma. He died soon afterward at Onslow Memorial Hospital, with Ramsey by his side.</p><p>From there, Ramsey's health declined. He began experiencing chest pain and other panic-like symptoms. After a while he had trouble standing on the field without feeling nauseous. </p><p>He still remembers the last pitch he threw: “a fastball,” he recalled without hesitation. </p><p>Still, after managing to graduate in 1998, he landed a series of teaching and coaching jobs in Wilmington and Jacksonville. But panic continued to plague him. </p><p>Brian Stewart, who previously worked with Ramsey at Hoggard High School and now coaches Ashley, recalled how Ramsey once had a panic attack when Jacksonville played Ashley. Ramsey was the only licensed driver with the Jacksonville team, but was in poor shape. So Stewart drove the bus for him back to Jacksonville. </p><p>By 2005, Ramsey's condition forced him onto government disability, where he remains.</p><h3>Comfort zone</h3>
<p>He lives in a modest house on the edge of Jacksonville with his mother and 14-year-old son. He had the garage remodeled into what resembles a studio apartment, a comfort zone he rarely leaves. (He chuckled recently about how he had never stepped foot in his backyard.) His den includes a living room area with recliners, a couch and a big-screen television for watching ESPN. A pass-through opens into his bedroom so friends can sit and talk to him at the counter when he feels too ill to sit upright. </p><p>Up until a few months ago, Ramsey said he spent 24 hours a day in bed. The hair on his right leg had worn off from lying down. Now, he manages to spend a few hours out of bed, often on a tablet posting messages about baseball to NCPreps.com. </p><p>Though open about his condition, one might have trouble believing Ramsey has an anxiety disorder just by talking to him. He cracks jokes and carries on conversations with the skill of a sportscaster. And memory seems to come easy. Ask him and he quickly recalls statistics from games he played, pitches he threw and even batters who got a hit off him. </p><p>Memorabilia is scattered around the house – old pictures, newspaper clippings and magazines stuffed into cabinets and drawers. He picks them up and points to different players, recalling where their careers took them. </p><p>He felt well enough earlier this month to visit a private indoor batting cage in a warehouse owned by a friend off a gravel road a mile or so from his home. He dropped several balls into the pitching machine and watched as they flew across home plate, remembering when he used to do the throwing. </p><p>During a phone conversation later that week, Ramsey said the father of the boy to whom he had provided pointers via email called and the two spoke for three hours. Now the father and son planned to visit Ramsey, including possibly a trip to the batting cage. </p><p>“I told him, 'I might be able to last 30 minutes; I might be able to last an hour,' ” said Ramsey, sounding excited. “He doesn't care. He's just appreciative.” </p><p><i></p><p>StarNews staff writer <a href="http://www.starnewsonline.com/section/topic16"><b>Chuck Carree</b></a> contributed reporting for this story.</i> </p><p><a href="http://www.starnewsonline.com/section/topic9904"><b>Brian Freskos</b></a>: 343-2327</p><p>On <a href="http://www.starnewsonline.com/section/news41"><b>Twitter</b></a>: @BrianFreskos</p>